Nurses Testify about Nursing Shortage

another hearing - this time on the shortage at VA hospitals......More staff nurse testimony......

"ANA Addresses the Impact of the Nursing Shortage at Senate Committee Hearing -

Washington, DC, June 15 -

Today before the Senate Committee on Veteran's Affairs, staff nurse Sandra McMeans, RN, testified on behalf of the American Nurses Association (ANA) regarding the looming nursing shortage and its impact on the Department of Veterans Affairs.

ANA is concerned by current staffing constraints and by reports showing that the nursing workforce will soon fall short of the demand for nursing services. As the Veterans Health Administration (VHA) employs the largest nursing workforce in the nation, the emerging shortage could soon have an impact on the health care services provided to America's veterans.

ANA maintains that the reasons for the current shortage and the answers to the impending shortage are multifaceted. Of particular concern is the negative impact today's working environment is having on the retention of registered nurses as well as the ability of the profession to recruit students. Ms. McMeans' statement highlighted the fact that enrollments in nursing schools have dropped in each of the last six consecutive years.

As a staff nurse and president of the West Virginia Nurses Association Local 203 bargaining unit, McMeans knows first-hand the hardships faced by today's nurses, "Nurses in Veterans Administration (VA) medical centers in particular are being confronted by staff downsizing, increased patient acuity, shorter hospital stays, bed closures and flat-lined budgets. These changes have caused such a deterioration on the work environment that nurses are opting not to
accept staff nurse positions."

In her written testimony, McMeans provided the committee with an ANA supported integrated state and federal legislative campaign that addresses the current and impending nursing shortage - a campaign which is applicable to the VHA as well as other hospitals. Key federal initiatives addressed in the comments included elimination of mandatory overtime, models for adequate staffing, support for nurse education and locality pay.

Dr. Thomas Garthwaite, Undersecretary for Health at the VHA, also testified at the hearing. "I am concerned that the use of overtime is increasing," stated Garthwaite. "This suggests that we have some staffing issues." In the five years between 1995 and 2000, the VA has downsized its RN workforce dramatically. At the same time, the VHA has brought 500,000 additional veterans into the health system, and cut the amount spent per
patient by 24 percent.

McMeans told the committee that no effort to address the nursing shortage will be a success unless the problems of the work environment are addressed. "After all," said McMeans, "how many of us would want to work in an environment where we have little to no control over the number of hours that we work, the quality of the work we produce, or the ability to change our work environment." http://www.ana.org/pressrel/2001/pr0614.htm
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Thanks for your post jt. I received a flyer in the mail yesterday
from our state represenative James Casorio. I hear he is a good
guy, but I was somewhat disconcerted by his mail. The title is "Casorio Fights for Nurses in Pennsylvania!" He goes on to state that he supports legislation to prohibit MOT, boost funding for hospitals and healthcare systems to maintain adequate staffing levels and attract and maintain highly trained nurses and other staff, and provide increased funding through scholarship and loan forgiveness....etc. Now, I am glad for the direct mail education to the public, but..........

I also think that we have recently found that our plight has reached our government officials. My ambivilence to this type of mailer is that 1) I looked on the Pa Legislature website, and Mr. Casorio is not on any committee working on these issues, and althought this type of mailer somewhat educates the public on the plight of nurses, I feel it is more promotion of the politicker. (Maybe I shouldn't look a gift horse in the mouth.!!!) and 2) I am very leery of giving the hospitals funding for staffing levels. How will they be accountable for this money and will it result in more paperwork for the nurse?
I have decided to visit or call Mr. Casorio in the near future to discuss these issues.
I agree with Ms. Mc Mean's statement in jt's post about the quality of the work environment. These are the issues I would like to see addressed. we need to see solutions now.
Anyone else out there have a comment on James Casorio' mailer?
Carrie

Last edit by cargal on Jun 23, '01

Jun 23, '01

I understand the nursing shortage is becoming or will become cirtical in the future. However, we should all remember that it is this shortage that has placed nursing in our federal and state legislature.

Prior to this shortage, we could barely get anyone to listen. We should not be so quick in fixing this problem. We should by all means exploit every opportunity to get substantial changes in law and respect for all nurses.

Should working conditions, benefits and pay increase? Absolutely, and now is the time to assist those in power to make critical and substantial changes.

We should not task ourselves to find more nurses or force more overtime. We should task ourselves to change nursing. To make nursing, a profession, that our young people would be proud and honored to become. We can not choose the profession or job careers of those behind us, however, we can make changes in pay, respect and working conditions which by default will cause an increase in nursing school enrollment.

We who are presently nurses will benefit by the shortage. Suffer, yes! But suffering has always occurred prior to gain.

Sometimes, it is more important in "how" we fix it, than "that" we fix it.

Just a thought !!

Jun 23, '01

"I am very leery of giving the hospitals funding for staffing levels. How will they be accountable for this money and will it result in more paperwork for the nurse?
I have decided to visit or call Mr. Casorio in the near future to discuss these issues. "

Its great you will be visiting your legislator to discuss these issues. They need to learn a few things. Maybe he could give you the list of his peers who are on the health committees in your state capitol & you could send them a note about it too. This might help if you want to refer to it when youre explaining things to them:

Part of what we proposed in the NY legislature, thru our state nurses association, to make the hospital accountable is the following.....

"In the current crisis in direct care, employers indeed find it difficult to recruit and retain nurse staff --
a situation attributable to the intolerable working environment THEY created.........

Safe Staffing Legislation Introduced: The New York State Nurses Association's proposed safe staffing legislation has been introduced in the New York Senate by Senate Health Committee Chair, Kemp Hannon. (S. 4779) and in the State Assembly by Assembly Health Committee Chair Richard Gottfried (A.9073). The bill would direct the Department of Health to establish a formula that healthcare facilities within the state must apply to determine appropriate staffing levels.

This legislation requires that staffing determinations result, in part, from the recommendations of those that are on the frontline of the delivery system, the nurses at the bedside. The legislation requires each facility to establish a committee representing direct care nurses to collaborate with facility management to implement the staffing plan. The statewide formula will be flexible enough to reflect the different characteristics of patients, personnel and facilities across the state.

*** Facilities found not to be in compliance would face STIFF PENALTIES as well as public disclosure that the facility failed to meet safe staffing standards. ***

Collect and Disclose Staffing Ratios: Nurses know that appropriate staffing affects patient outcomes. NYSNA wrote the Staffing Disclosure Bill (Assembly Bill 2581/Senate Bill 510)
that requires hospitals and nursing homes to disclose and report nurse-to-patient staffing ratios and the mix of licensed and unlicensed personnel. It calls for facilities to disclose information indicating the quality of nursing care, such as the incidence of nosocomial infections, patient falls, and pressure ulcers. Public knowledge of staffing practices will help put "market pressure" on facilities.

Healthcare facilities would be required to collect data that reflects the quality of nursing care: patient-to-staff ratios, staffing mix, patient complications such as pressure ulcers, in-hospital infections, and medication errors. This information should be part of "hospital report cards" and be made available to the public....

Establish reimbursement rates for health care facilities to reflect costs of recruiting and retaining staff:
TIE funding to EVIDENCE of improvements in recruitment and retention.
Enhance the funding to the nursing department, NOT to a facility's general operating costs.
Connect funding enhancements with improved staffing.

State reimbursements for health care should reward facilities that are using their resources to provide quality nursing care. Enhanced funding for health care institutions should be tied to the EVIDENCE of increased recruitment and retention, and go directly to the nursing department, rather than be provided as a rate adjustment that goes to facilities' overall operating costs.
After a year end review, if it is found that facility has not met the recruitment/retention goals for which it received funding from the State to meet, the State would be entitled to a refund of those monies............."http://www.nysna.org/PROGRAMS/LEG/points/solutions.htm

So in other words, they cant just get more money from the government to fund hiring nurses & then line their own pockets with it instead. They'd have to prove they used it for recruitment, retention, & staffing improvements & the proof would be better staffing levels. If a year-end review shows they didnt do that, theyd have to REFUND the state back the funding they were given. Thats a pretty strong incentive for them to not just give lip service to how much they "value" nurses but to really work to make things better so nurses will want to work at that facility. The hospital has to collect the data - not us. Its their paperwork -not ours.
Good luck at your meeting!

Jun 23, '01

RNed,
What you say is a given and I couldn't agree more. Any thoughts on how to change Nursing or is it RN's themselves that have to change?

May 15, '06

hi - i'm currently a student LPN in PA and i am new to the forum. I have worked in the medical field a total of 15 yrs now - as a Med Secretary to Office EKG/Lab Tech to Med Assistant...as a med assist I am only allowed to work in dr offices,however, being in the dr offices for the past 10 yrs, i have been laid off 2x due to health insurance cutbacks...(dr. no longer able to afford me...) all i want to do now is become a "real" nurse! I just have a question, if u don't mind...in my area (wilkes-barre) there is a shortage of nurses as there is nationwide, but what i don't understand is that there is definitely no shortage on nsg students...the competition around here is tough with 2-3 yr waiting periods to attend RN classes for each of the3 colleges that offer nsg programs. that's why i chose a 12 mo LPN prog for now...i'm currently on a 2yr waiting list! hoping... anyway, in my class alone there are 46 students, with 57 in the senior class now and 60 more in the freshmen class following us! to me, it seems that nurses are out there but no one hires! in the hospital where i currently work as an aide, i see so many RNs and LPNs working doubles 5-7 days a week and floating floors and units. is that what's happening out there - lots of qualified nurses looking for jobs, lots of facilities needing nurses, but is there no funding to hire them??????? that's a shame!

May 15, '06

"as well as the ability of the profession to recruit students. Ms. McMeans' statement highlighted the fact that enrollments in nursing schools have dropped in each of the last six consecutive years."

What??? Since when are nursing schools empty or even easy to get into? Enrollment is dropping? Since when? We all sit here for 2 and 3 years to get into school and someone is trying to say that enrollment is dropping and iterest in the profession is dropping. I say "Yeah Right"

May 17, '06

Uh, this thread is almost five years old. That might be part of the reason.

May 21, '06

The key to dealing with the work environment for nurses is holding nursing management accountable. A very successful program is 180 degree evaluations. Staff evaluate thier managers. Another solution is to strengthen nurse practice acts so that there are standards of practice that are specific to nurse managers.

May 21, '06

I couldn't agree with you more. I am contemplating quitting my job (transferring to another floor) as soon as I can due to management issues. I am a new grad RN and have spent several sessions with my Nurse Manager regarding floor issues (CNA insubordination/delegation, assigning patients based on acuity to LPNs and RNs, instead of randomly, look they do now, and team building). It seems that my issues fall on deaf ears and other RNs have presented these issues before me to no avail. It also seems as if upper management is aware of this, as well. I am not the first nurse to address these issues. I realize that there is only so much that I can do, and don't want to invest more time and energy on something beyond my control. Now, I know to look for a floor with a manager with great leadership skills who continues to increase the standard of excellence for the floor.

May 21, '06

I am proud to say I am from the same state as Ms. McMeans and about a year or two ago a state law was passed that nurses can not be mandated to stay over nor have mandated overtime. Likewise at the same time we lost our critical bonus for working any overtime if we wanted to and it seems like the number of full time nurses has decreased and the number of per diem (prn) positions and agency nurses have increased.